Medicaid

Tea party activists in Ohio want to use a unique weapon to fight continued efforts to expand Medicaid: the Internal Revenue Service.

In a confidential email sent to fellow Ohio tea party leaders and obtained by The Associated Press, Tom Zawistowski lays out a strategy for invoking a little-known IRS provision that allows citizens to challenge executive salaries and the nonprofit statuses of charitable hospitals.

In a phone interview, Zawistowski calls it "hilarious" that tea party groups that came under extra scrutiny by the IRS are now using an IRS law to target others.

After months of discussion and debate and several days of lingering questions, the state has a new two-year, $62 billion budget. The signing came with just hours to go before the new fiscal year.

The budget includes a gradual income tax cut over three years for everyone, a 50 percent income tax cut for small businesses, an increase in the state sales tax along with an expansion to digital downloads and magazine subscriptions, and some property tax changes. Gov. John Kasich said he was pleased with it, though it didn’t include his proposed Medicaid expansion.

The committee working out the differences between the House and Senate versions of the state budget now has updated estimates on tax revenues and Medicaid. Those numbers were higher than estimates, but they came with a caution.

The Office of Budget and Management estimates $709 million more in tax revenues above the original forecast, but budget director Tim Keen says after payments to the federal government for unemployment benefits, transfers to the rainy day fund and other issues are paid, there will only be about $397 million extra to do more tax cuts or spending.

An Ohio legislative committee is scheduled to hear two Medicaid proposals today as lawmakers try to find common ground on changes to the health program.

One bill is aimed at curbing Medicaid costs and making the program more efficient while neither expanding it or cutting beneficiaries. The bipartisan bill's sponsors have described the legislation as a starting point for discussions.

Ohio Governor John Kasich says he is not giving up his push for expansion of Medicaid as part of the proposed two year state budget. Some groups have suggested putting the issue on the ballot so that Ohioans can decide whether to expand Medicaid. Governor Kasich says he’s not opposed to that idea.

Groups that want Medicaid expansion are looking at their options right now. John Begala with the Center for Community Solutions wants Medicaid expansion as part of the state budget. But he says he’s willing to give lawmakers time to come up with Medicaid reforms that would allow low income Ohioans to purchase private health insurance with federal dollars. Still, Begala says he says his group is not willing to wait forever. He says if they don’t do it by the end of this year, his group is looking at another alternative: letting Ohio voters decide whether to expand Medicaid.

It looks like Medicaid expansion won’t likely be part of the proposed two year state budget that will come out of the Ohio Senate.

Governor John Kasich, Business leaders and even Democrats want Medicaid expansion in the Ohio Budget. But Republican Ohio Senate President Keith Faber says that’s unlikely.

"You need two chambers to move a bill and the house has indicated they simply don’t have the votes to get Medicaid expansion done in the budget," says Faber. "Therefore I do not believe Medicaid expansion is on the table as it relates to this legislation in the budget."